CLINICAL PRESENTATION AND DIAGNOSIS OF BREAST TUMOURS
CLINICAL PRESENTATIONS AND DIAGNOSIS OF BREAST TUMOURS
@Robindiagnostics Ltd
www.Robindiagnosticsltd.com
OUTLINE
INTRODUCTION
EPIDEMIOLOGY OF BREAST TUMOUR
RISKS FACTORS
CLINICAL PRESENTATION OF BREAST TUMOURS
CLASSIFICATION OF BREAST TUMOURS
DIAGNOSIS OF BREAST TUMOURS
PREVENTION
CONCLUSION
REFERENCES
OBJECTIVES
1. To understand the basic histological and anatomical structure of the breast
2. To Know the pathological changes that can lead to breast tumour
3. To know the importance of medical scientist in diagnosing of breast tumours
INTRODUCTION
Definition
Tumour can be defined as an abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should. Tumors may be benign or malignant (NIH, 2021).
Cancer can be said to occur when changes called mutations take place in genes that regulate cell growth (CDC, 2021).
Breast cancer is cancer that develops in breast cells. Typically, the cancer forms in either the lobules or the ducts of the breast (CDC, 2021).
Fig: 1.0 Histological and Anatomical structures of the breast.
The breast has two principal regions:
The conical to pendulous body, with the nipple at its apex,
An extension toward the armpit called the axillary tail.
Histologically the breast is made of the epithelial and the stromal components.
Lymphatics of the axillary tail are especially important as a route of breast cancer metastasis (Kenneth, 2008).
EPIDEMIOLOGY OF BREAST TUMOUR
There were about 2.3 million women diagnosed with breast cancer and 685 000 deaths globally in 2020. As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer (WHO, 2021).
In Nigeria, breast cancer is the leading cause of cancer deaths currently, representing about 23% of all cancer cases and approximately 18% percent of deaths are attributed to it in the country (Healththink, 2021).
In Jos Plateau State the most frequent cancers were those of the breast, cervical, prostate, lymphoma, and liver cancers (Barnabas et al., 2019).
RISKS FACTORS
1. Race / Ethnicity
2. Family history of breast cancer
3. Geographic factors
4. Gender and Age
5. Ionising radiation
6. Reproductive history
7. Hormones
8. Other risks factors eg obesity etc (Harsh et al., 2010).
CLINICAL PRESENTATION OF BREAST TUMOURS
1. Pain
2. Nipple discharge
3. Inflammation
4. Lumpiness
5. Palpable masses
6. Gynecomastia
7. Stiffness of the breast (Harsh et al., 2010).
CLASSIFICATION OF BREAST TUMOURS
Breast tumour can be divided into benign and malignant tumours
Benign breast tumour includes.
1. Fibroadenoma
2. Intraductal papilloma
3. Phyllodes tumour
Malignant breast tumour can be classified into
1. Histological / Morphological classification
2. Molecular classification (Kumar et al., 2018).
Histological classification of breast
Histological classification of breast carcinoma is as follows:
Non-Invasive, which are.
• Ductal carcinoma insitu
• Lobular carcinoma insitu
Invasive, which are.
• Invasive ductal carcinoma – 70% to 80%
• Invasive lobular carcinoma – 10% to 15%
• Carcinoma with medullary features – 5%
• Mucinous carcinoma (colloid carcinoma) – 5%
• Tubular carcinoma – 5% and other types (Kumar et al., 2018).
Molecular Classification
1. ER positive (HER2 negative; 50%–65% of cancers)
2. HER2 positive (ER positive or negative; 10%–20% of cancers)
3. Triple negative (ER, PR, and HER2 negative; 10%–20%of cancers) (Kumar et al., 2018).
STAGES OF BREAST CANCERS
Breast cancer has 5 main stages: stages 0 to 5.
1. Stage 0 breast cancer
2. Stage 1 breast cancer
3. Stage 2 breast cancer
4. Stage 3 breast cancer
5. Stage 4 breast cancer
In Stage 4 breast cancer can have a tumor of any size, and its cancer cells have spread to nearby and distant lymph nodes as well as distant organs (Jaime and Christina, 2021).
DIAGNOSIS OF BREAST TUMOURS
1. Self-Exam (BSE)
2. Histopathology test e.g. H&E, FISH and IHC.
3. Hematological test e.g. FBC.
4. Biochemical test e.g. liver enzyme, blood sugar, k, biomarker CA15.3, CA125, CEA, (BCO, 2021).
SELF-EXAM (BSE)
BENIN BREAST TUMOURS
Non-Invasive breast tumour
Invasive Breast Tumour
IHC Stained photomicrograph.
PREVENTION OF BREAST TUMOURS
1. Prolonged breastfeeding.
2. Regular physical activity.
3. Weight control.
4. Avoidance of harmful use of alcohol.
5. Avoidance of exposure to tobacco smoke.
6. Avoidance of prolonged use of hormones; and
7. Avoidance of excessive radiation exposure.
CONCLUSION
In conclusion, with the high incidence and mortality rate associated with breast cancer in low- and middle-income countries like Nigeria, there is a need for efforts to be made to create more awareness about the disease, especially among uneducated women and proper structures for early detection should be provided.
RECOMMENDATION
1. Proper sex education and avoid the use of contraceptives.
2. Young ladies should avoid late and early marriage.
3. Practice periodic breast self-examination
4. Avoid the use of drugs in controlling painful ovulation and menstrual cycle.
5. Practice daily exercise.
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